Final answer:
The 65-year-old man on a private pay-for-service plan should call the service provider to check if his plan covers his doctor's visit or get a written advance coverage determination. Suing should be a last resort, and it's false that the patient has no options.
Step-by-step explanation:
If a 65-year-old man who joined a private pay-for-service plan is worried that his next doctor's visit will not be covered by the plan, he should consider the following actions:
- Call the service provider to see if his plan covers the services. This is often the most direct method to obtain information about coverage specifics.
- Get a written advance coverage determination for the service, which can provide a guarantee of coverage before the service is provided.
- Suing the plan is generally not a first recourse and can be lengthy and expensive. It should be considered only after exhausting other options.
- It is not true that the patient has no options. The first two steps should provide clarity on coverage.
Misunderstandings about coverage can lead to significant financial concerns, especially for those on fixed incomes, like many seniors. Additional info about Parts A and B of Medicare and the Affordable Care Act can be help clarify options and rights for individuals seeking coverage.